Doctors' protest over asylum seekers shows us what real morality is all about

By Waleed Aly

UpdatedOctober 15, 2015 — 7.45pmfirst published at 2.30pm

It's easy to forget there was a time that we didn't justify our asylum seeker policies by claiming they were "stopping deaths at sea". Once upon the Howard era, we were candid enough to say flat out it was a bald assertion of sovereignty, bolstered by a general hunch we didn't really like these people very much.

That's what the whole "children overboard" thing was about, really: one final overstatement in a relentlessly prosecuted argument that boat people weren't really people at all. Hence: queue jumpers, possibly terrorists, the kind of unscrupulous cynics who'd drop their own kids in the ocean if it helped them cheat their way in.

Illustration: Andrew Dyson

Viewed through that history we can see just how remarkable the transformation has been. "Deaths at sea" allowed us to take a crassly nationalistic argument and turn it instead into a moral one. The odd "economic refugees" or "Christians only" snipe aside, we stopped attacking refugees directly and attacked people smugglers instead. Brutality was transformed into a kind of muscular compassion, and every confirmation of the psychological (and sometimes physical) destruction of people under our jurisdiction was rendered a sober necessity. Deterrence, no matter what horrors it entailed, became the only moral position. That, insisted Malcolm Turnbull this week, is "the melancholy truth".

And it is precisely this that makes the current refusal of doctors at Melbourne's Royal Children's Hospital to discharge their asylum-seeker patients if they are to be returned to immigration detention so potent. In a debate that is so constant and repetitive it has become mere auditory wallpaper, theirs is the most disruptive intervention in years. And that's because it is so explicitly not political.

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Illustration: Simon Letch

This is ostensibly a clinical decision: doctors insisting detention would further damage those under their care, and who are therefore bound not to subject them to it. But beneath every clinical judgment lies an ethical one, too. That's why doctors swear oaths. Medicine is more than a technocratic application of treatments; it is the practice of an ethos of service and care. When doctors declare they cannot return patients to immigration detention, they are saying it would be immoral for them to do so: a violation of their covenant.

Government policy cannot simply trump such oaths. It cannot erase the age-old ethical foundations of an entire profession. And that is why the doctors' stance is so impervious to the predictable retorts of politics. No amount of invoking "deaths at sea" can compel a doctor to harm her patient. We're witnessing two contrasting moral languages here that proceed from different assumptions of what constitutes the good. And there's a lot we can learn from identifying those differences.

The doctors' moral focus is on the individual patient. They do not ask, for example, whether that patient is worthy of treatment. They don't give less care to an abusive drunkard than to an altruistic social worker. They don't refuse to treat an elderly patient simply because it might be more productive to prioritise treating younger people with their prime decades still in front of them.

They reject any notion that a "lesser" person should be sacrificed for the benefit of someone – or something – "greater". Their morality is about the unquestioned dignity of the person before them; a dignity that exists for no reason other than that this is a human being in need of care.

In this sense it has clear liberal (or perhaps personalist) overtones. And for that reason, it is far from niche. This idea – that each individual is sacred; that no individual can simply be sacrificed in order save others – lies at the heart of our civilisation.

It's the reason we've prohibited torture. It's why we've abandoned the death penalty in this country, no matter the crime. Indeed, it's the basis of the whole idea of human rights, which this nation was so instrumental in distilling into law. It's meant to be the basis on which we do our public reasoning. So it's hugely significant that right now, it's also the opposite of the argument our politicians are running.

"Deaths at sea" only masks the nature of the morality we're adopting here. So let's be clear what it ultimately means: that we sacrifice some people for the sake of others. That individual people will be brutalised and occasionally destroyed, so that others' lives may be saved.

I cannot claim there's no moral case to be made to that effect at all (although I doubt the claim there is simply no other way to save these lives). It's just that it is a starkly utilitarian one: greatest good for the greatest number, and all that.

That might be fine if it's a moral vision we habitually adopt, but it's not. We don't, say, force people to donate their organs, even though we know this would save lives. As a nation we've typically rejected this sort of approach because it has a nasty habit of being unprincipled. It's the morality that can make anything from slavery, to torture, to Stalinism possible: an ethos that has no rules, only results; where nothing has intrinsic value except whatever "greater good" you wish to serve.

Under this sort of cover, almost any atrocity can be sanctified. And if it can do even that sort of heavy lifting, then what's the mental disintegration of a few hundred asylum seekers – whether they're children or not?

That's how we've reached the point where we no longer even need to pretend our detention centres are anything other than (in Patrick McGorry's phrase) "factories for producing mental illness". We've developed a morality that can absorb that. We just can't recognise how dramatic that is because our political debate is incapable of teasing out the moral assumptions that made that possible.

But every now and then something happens that reveals the smallness of politics. Perhaps we shouldn't be altogether surprised that this time it was the stand of a few Melbourne doctors. After all, they clearly understand the ethics on which their profession is based. And their clarity leaves us with the question of whether the rest of us can make anything like the same claim.

Waleed Aly is a Fairfax Media columnist and winner of the 2014 Walkley award for best columnist. He also lectures in politics at Monash University.